Dermatology, Cosmetic Surgery, Mohs Micrographic Skin Cancer Surgery & Laser Surgery

Hot Tub Folliculitis

It’s that time of year. The nights are still cool but you want to be outside and rip the cover off your hot tub that has been in hibernation all winter and jump right in, WAIT!!! That warm whirlpool has been brewing some bacteria for the past months. There are a few things you need know before you enjoy a little warm water massage.

Last week an 11yr old boy came into the office complaining of a rash that appeared on his lower abdomen 3 days earlier. The appearance of his rash and it’s location were a certain giveaway for hot tub folliculitis. After some questioning, the patient’s dad let me know their hot tub had been broken and when it was finally fixed his son was so excited he couldn’t wait for dad to check the chlorine levels to get in. The next day his rash appeared.

Hot tub folliculitis is caused by the bacteria Pseudomonas aeruginosa. This form of bacteria thrives in hot tubs, especially hot tubs made of wood unless the water’s acid and chlorine levels are strictly controlled. Symptoms can be seen several hours to 2 days after coming in contact with the bacteria. It first appears as red itchy bumps and can progress to large, dark red, tender nodules filled with pus. The rash may be worse under swimsuit area where bacteria has been trapped for a longer period of time. If the condition is mild no treatment may be necessary. Antibiotics may be prescribed if the case is more severe. In the case of our 11 year old patient, he was put on oral antibiotics.  At his check-up yesterday his rash was much improved.

Moral of the story: Clean and chlorine will keep you in the clear

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